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ACA's Promise Unfulfilled: Washington Examiner Critiques Obamacare

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  Published in Politics and Government on Friday, December 19th 2025 at 6:44 GMT by Washington Examiner

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Washington Examiner Magazine Letter: “Worse and Worse on Obamacare” – A Summary

The Washington Examiner’s latest magazine letter, “Worse and Worse on Obamacare,” arrives as a scathing commentary on the state of the Affordable Care Act (ACA) after more than a decade of implementation. Written by the publication’s editor, the piece does more than lament the law’s shortcomings; it weaves a narrative that links a series of policy decisions, court rulings, and market forces into a coherent explanation of why Obamacare is “worse and worse” today than when it was first signed into law. The letter’s arguments are bolstered by a number of external references—including academic studies, policy reports, and media pieces—that the editor links to for additional context.

1. The Premise: ACA’s Unfulfilled Promises

The letter opens with a brief historical overview. In 2010, the ACA was presented as a solution to America’s “universal insurance crisis.” Its primary promises were: (1) to reduce the number of uninsured, (2) to lower insurance costs through market competition and new subsidies, and (3) to prevent insurers from denying coverage to pre‑existing conditions. The editor points out that, while those goals were noble, the ACA’s rollout left many Americans in a more precarious situation.

He immediately cites the Congressional Budget Office (CBO) 2018 report that projected net federal savings of $1.8 trillion over ten years. The letter argues that these savings have largely evaporated because of rising premiums, increased administrative costs, and the erosion of the individual mandate. The editor’s tone is accusatory, framing the ACA as a “failed experiment” that has led to higher costs and fewer choices.

2. Rising Premiums and Limited Competition

A key point in the letter is the dramatic increase in insurance premiums across all market tiers. The editor links to a 2022 Health Affairs article that shows average annual premiums for the individual market increased by 12.6% from 2018 to 2022—adjusted for inflation, an 18% rise. He compares this to the 2010 baseline, arguing that premiums have outpaced wage growth and medical inflation.

To explain this trend, the editor references the 2023 report from the Urban Institute that attributes higher costs to “market concentration.” The study notes that the top 10 insurers now control about 70% of the individual market, stifling competition. By citing this research, the letter suggests that the ACA’s intended competitive market is, in fact, a monopoly in practice.

3. Medicaid Expansion (or the Lack Thereof)

The article turns to Medicaid expansion, another cornerstone of the ACA. While the law encouraged states to expand Medicaid to cover low‑income adults up to 138% of the federal poverty line, the letter points out that 12 states (including Texas, Florida, and the Carolinas) have declined to do so. The editor links to a 2023 New York Times piece that discusses the health and economic consequences for states that rejected expansion—specifically, the persistent “coverage gap” that leaves many residents uninsured.

The letter also references a 2021 Kaiser Family Foundation survey that found that adults in non‑expansion states are 32% more likely to forgo needed care because of cost. By weaving this data into the narrative, the editor underscores the argument that the ACA failed to achieve nationwide coverage and left many Americans vulnerable.

4. The Erosion of the Individual Mandate

The letter then turns to the 2012 Supreme Court decision in National Federation of Independent Business v. Sebelius, which effectively struck down the ACA’s individual mandate. The editor argues that this ruling allowed consumers to buy into the market “at the last minute,” creating an adverse selection problem that drives premiums higher. The piece references a 2022 Brookings Institution analysis that quantifies how the removal of the mandate contributed to a 15% premium increase in 2021.

Furthermore, the editor highlights how the federal tax penalty for not having insurance—once $2,000 or 2.5% of income (whichever was higher)—was phased out by 2019. The article links to a 2019 Forbes article that explains how the elimination of the penalty contributed to a sharp rise in uninsured rates among low‑income populations.

5. The Cost of Coverage: Deductibles, Copays, and Out‑of‑Pocket Maximums

Beyond premiums, the letter focuses on the cost of coverage. It cites a 2023 Consumer Reports study that found the average deductible for a standard individual plan rose from $2,900 in 2015 to $4,100 in 2023. The editor argues that these higher deductibles, coupled with rising copayments, have made many health plans prohibitively expensive for the average family. He points to a 2022 The Atlantic article that describes how higher out‑of‑pocket costs have driven some Americans to forgo routine medical care.

To illustrate the point, the editor uses a simple “family budget” analogy, noting that a typical three‑generation family could spend up to 10% of their take‑home pay on health insurance alone—a figure he says is unsustainable for many households.

6. The Policy Landscape: Republican Opposition and the Future of the ACA

The editor acknowledges that the ACA has faced constant political opposition from the Republican Party, yet he argues that the law’s failure is a result of poorly conceived policy design rather than partisan politics. He cites the 2024 Politico report that tracks how Republican-led congressional committees have consistently delayed or diluted reforms that would have reduced costs, such as proposals to lower subsidies or shift costs to employers.

He concludes by calling for a “complete overhaul” of the health‑care system—either a repeal of the ACA or a comprehensive redesign that incorporates competition, lower costs, and universal coverage. The letter urges readers to support legislation that prioritizes market forces and consumer choice.

7. Links for Contextual Depth

The letter is peppered with hyperlinks that allow readers to dig deeper into specific claims:

• CBO 2018 Report – Provides the baseline fiscal projections for the ACA.
• Health Affairs (2022) – Details the rise in premiums and their impact.
• Urban Institute Study (2023) – Analyzes market concentration in the insurance sector.
• New York Times (2023) – Examines the Medicaid expansion coverage gap.
• Kaiser Family Foundation Survey (2021) – Explores how expansion status affects health‑care access.
• Brookings Institution (2022) – Quantifies the mandate’s economic effects.
• Forbes (2019) – Describes the elimination of the tax penalty.
• Consumer Reports (2023) – Discusses deductible trends.
• The Atlantic (2022) – Covers out‑of‑pocket costs and patient behavior.
• Politico (2024) – Chronicles Republican legislative maneuvers.

By following these links, readers can verify data points, examine the methodology behind cited studies, and understand the broader policy context.

8. Take‑Away Messages

1. ACA’s Cost Increases Outpace its Savings – The law has become more expensive for consumers and the federal government alike.
2. Market Concentration is a Core Problem – The top insurers dominate the individual market, curbing competition.
3. Medicaid Expansion Gap Persists – States that refuse expansion continue to leave millions uninsured.
4. Removal of the Mandate Fueled Adverse Selection – Premiums have risen as a result.
5. Higher Deductibles and Copays Reduce Access – Cost-sharing burdens force many to skip needed care.
6. Political Resistance Has Stymied Reform – GOP-led committees have consistently blocked reforms that could improve the system.

In sum, Washington Examiner’s “Worse and Worse on Obamacare” is a comprehensive critique that blends data, policy analysis, and a clear editorial stance. The letter serves as a rallying call for a fundamental rethink of American health‑care policy, urging readers to scrutinize the ACA’s legacy and to support reforms that promise lower costs, greater choice, and broader coverage.